Orthopedic Care and Consultation
Atlas fractures can be stable or unstable injuries. This fracture has very high association with injuries to other areas of the spine.
A fracture of atlas vertebra should cause enough alert to search for injuries in other region of the spine.
Almost 43% of all C-1 fractures are found to be associated with a C-2 fracture.
Atlas fractures have been divided into following 5 types. [Read more...]
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Occipital condyle fractures have previously been viewed as relatively uncommon injuries; but with the increased utilization of CT scanning with reconstructions in the evaluation of suspected spine trauma patients, an increased incidence has been noted. It has been reported to occur in 3-15% of trauma patients. Presence of these fractures indicate high injury trauma.
Occipital condyle fractures may be stable or represent the bony component of occipitocervical dissociation.
Montesano classified these fractures into three categories. [Read more...]
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Arthrodesis is also known as artificial ankylosis or syndesis. It is an operation designed to produce bony ankylosis of a diseased joint often done in joints or bones near the joint affected by infection, tumors, trauma, and paralytic conditions.
It is also used in certain cases of painful osteoarthritis and rheumatoid arthritis as a pain relieving measure.
It is important to understand the difference between ankylosis and arthrodesis. Ankylosis refers to a stiff joint irrespective of the cause for stiffness. Arthrodesis always means that the joint has been fused surgically.
The main disadvantage of arthrodesis is that it sacrifices the movement of joint. Thus the function of the limb is definitely compromised. For example, in the lower limb, energy requirements for ambulation are increased. [Read more...]
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Fracture upper end humerus are common fractures in children as well in adults and elderly. However fractures behave differently in different age groups.
While elderly patients can be treated on conservatively The fractures in an adult on the other hand would require operative treatment owing to the increased demands and active life style.
Most of these fractures in children also unite on conservative treatment. Only those fractures which are severely displaced would need an operative intervention.
The following xrays are of 10 years old child who suffered fracture of upper end of humerus after he fell from height while he was flying a kite.
The fracture is severely displaced as can be seen in the picture. [Read more...]
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The blood supply of the spinal cord is mainly dependent on three vessels. These are namely anterior median longitudinal arterial trunk and a pair of posterolateral trunks. These posterolateral trunks are situated near posterior nerve rootlets.
These longitudinal arterial trunks are largest in size in cervical and lumbar regions because the demand of grey matter is much more than white matter.
The size is much smaller in thoracic regions because of the same region.
Generally speaking the thoracic area is supplied poorly as compared to cervical and lumbar region. The blood supply is poorest between levels T4 and T9
However, these are not the sole vessels on which circulation of the spinal cord is dependent. There are many other reinforcing vessels. A list of other vessels supplying the spinal cord is as follows. [Read more...]
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Kirschner wires or K wires were invented by Martin Kirschner in 1909. They have a great role in management of orthopedic trauma and correction of deformities.
They are sharpened, smooth stainless steel pins which are available in different diameters and lengths.
They are used both in surgical and conservative management of fractures. In surgery they are either used to hold the fracture fragments temporarily before definitive implant is put or are used as for definitive treatment o fractures too. [Read more...]
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The amount of trauma required to produce a distal end radius fracture varies from minor fall to motor vehicle accidents.
Most of the patients present with a history of trauma and deformity in the wrist following the trauma. The elderly patients generally present with deformity in the wrist following fall on the hand.
The examination would reveal the deformity and give an idea about the injury to surrounding soft tissue structures. Functions of nerves, vessels and tendons should be checked. [Read more...]
Popularity: 3% [?]
Distal forearm fractures in forearm occur in children due to fall on outstretched hand.
This is an xray of 6 years old child who suffreed this injury ehn she slipped and fell on her hand.
The xray above is 5 days after closed reduction and plaster application.
These fractures respond very well to conservative treatment.
Popularity: 3% [?]
K wire is the short term for Kirchner Wire.
K wire is frequently used in treatment of fractures in children and in hand injuries among other things.
The xray below is post operative image of a 26 years old labroure who injured his hand due to work related injury.
He suffered from fracture of proximal phalanx of second and third digit.
The injury was treated with closed reduction and K wire fixation under C Arm.
The fracture has united after 4 weeks and patient has been put on mobilization exerecises.
Popularity: 6% [?]
If after fixation of a fracture, there is failure to unite within certain amount of time, there is danger of implant getting failed.
With improved qualities of implants, meticulous surgical techniques and careful postoperative protocols, the failures can be reduced.
But still failures do occur.
After a fracture is fixed there is kind of race between fracture union and implant fatigue. Fatigue is the progressive and localized structural damage that occurs in materials when a material is subjected to cyclic loading.
In other words every time an implant is subjected to stress, there occurs a damage to it. Repetitive damage accumulates over the periods and ultimately leads to breakage of the implant.
This is one kind of fixation failure. [Read more...]
Popularity: 6% [?]
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